Complications

Infections common to HIV/AIDS

Tuberculosis (TB). In resource-poor nations, TB is the most common opportunistic infection associated with HIV and a leading cause of death among people with AIDS. Millions of people are currently infected with both HIV and tuberculosis, and many experts consider the two diseases to be twin epidemics.

Salmonellosis. You contract this bacterial infection from contaminated food or water. Signs and symptoms include severe diarrhea, fever, chills, abdominal pain and, occasionally, vomiting. Although anyone exposed to salmonella bacteria can become sick, salmonellosis is far more common in HIV-positive people.

Cytomegalovirus. This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast milk. A healthy immune system inactivates the virus, and it remains dormant in your body. If your immune system weakens, the virus resurfaces — causing damage to your eyes, digestive tract, lungs or other organs.

Candidiasis. Candidiasis is a common HIV-related infection. It causes inflammation and a thick, white coating on the mucous membranes of your mouth, tongue, esophagus or vagina. Children may have especially severe symptoms in the mouth or esophagus, which can make eating painful.

Cryptococcal meningitis. Meningitis is an inflammation of the membranes and fluid surrounding your brain and spinal cord (meninges). Cryptococcal meningitis is a common central nervous system infection associated with HIV, caused by a fungus found in soil. The disease may also be associated with bird or bat droppings.

Toxoplasmosis. This potentially deadly infection is caused by Toxoplasma gondii, a parasite spread primarily by cats. Infected cats pass the parasites in their stools, and the parasites may then spread to other animals and humans.

Cryptosporidiosis. This infection is caused by an intestinal parasite that's commonly found in animals. You contract cryptosporidiosis when you ingest contaminated food or water. The parasite grows in your intestines and bile ducts, leading to severe, chronic diarrhea in people with AIDS.

Cancers common to HIV/AIDS

Kaposi's sarcoma. A tumor of the blood vessel walls, this cancer is rare in people not infected with HIV, but common in HIV-positive people.

Kaposi's sarcoma usually appears as pink, red or purple lesions on the skin and mouth. In people with darker skin, the lesions may look dark brown or black. Kaposi's sarcoma can also affect the internal organs, including the digestive tract and lungs.

Lymphomas. This type of cancer originates in your white blood cells and usually first appears in your lymph nodes. The most common early sign is painless swelling of the lymph nodes in your neck, armpit or groin.

Other complications

Wasting syndrome. Aggressive treatment regimens have reduced the number of cases of wasting syndrome, but it still affects many people with AIDS. It's defined as a loss of at least 10 percent of body weight, often accompanied by diarrhea, chronic weakness and fever.

Neurological complications. Although AIDS doesn't appear to infect the nerve cells, it can cause neurological symptoms such as confusion, forgetfulness, depression, anxiety and difficulty walking. One of the most common neurological complications is AIDS dementia complex, which leads to behavioral changes and diminished mental functioning.

Kidney disease. HIV-associated nephropathy (HIVAN) is an inflammation of the tiny filters in your kidneys that remove excess fluid and wastes from your bloodstream and pass them to your urine. Because of a genetic predisposition, the risk of developing HIVAN is much higher in blacks.

Regardless of CD4 count, antiretroviral therapy should be started in those diagnosed with HIVAN.

Common side effects of HIV medicines. American Family Physician. 2011;83:1456.

Preexposure prophylaxis for the prevention of HIV infection in the United States — 2014 clinical practice guideline. Atlanta, Ga. Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/pdf/guidelines/PrEPguidelines2014.pdf?elq=0a349f52dfa74f48ae554056bc0e027e&elqCampaignId=8040. Accessed May 16, 2014.

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